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Objectives@#To investigate trends of osteoporosis treatment rates, and factors affecting osteoporosis treatment after hip fracture admission within a single health care system in Hawaii. @*Methods@#A retrospective chart review was conducted of patients aged 50 years or older and hospitalized for hip fractures between January 1, 2011 and December 31, 2019 at Hawaii Pacific Health, a large health care system in Hawaii. We collected data on basic demographics and osteoporosis medication prescription from electronic medical records. We evaluated trends of osteoporosis treatment rates and performed logistic regression to determine factors associated with osteoporosis treatment. @*Results@#The mean for treatment rates for osteoporosis from 2011 to 2019 was 17.2% (range 8.8%-26.0%). From 2011 to 2019 there was a small increase in treatment rates from 16.3% in 2011 to 24.1% in 2019. Men were less likely to receive osteoporosis treatment after admission for hip fracture. Patients discharged to a facility were more likely to receive osteoporosis treatment. As compared to women, men who had a hip fracture were less likely to receive dual-energy X-ray absorptiometry scan, and osteoporosis medication before hip fracture admission. @*Conclusions@#The use of osteoporosis medication for secondary prevention after admission for hip fracture in Hawaii from 2011 to 2019 was low. However, there was a small increase in treatment rates from 2011 to 2019. Disparities in treatment of osteoporosis after hip fracture were noted in men. Significant work is needed to increase treatment rates further, and to address the disparity in osteoporosis treatment between men and women.
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Objectives@#To investigate trends of osteoporosis treatment rates, and factors affecting osteoporosis treatment after hip fracture admission within a single health care system in Hawaii. @*Methods@#A retrospective chart review was conducted of patients aged 50 years or older and hospitalized for hip fractures between January 1, 2011 and December 31, 2019 at Hawaii Pacific Health, a large health care system in Hawaii. We collected data on basic demographics and osteoporosis medication prescription from electronic medical records. We evaluated trends of osteoporosis treatment rates and performed logistic regression to determine factors associated with osteoporosis treatment. @*Results@#The mean for treatment rates for osteoporosis from 2011 to 2019 was 17.2% (range 8.8%-26.0%). From 2011 to 2019 there was a small increase in treatment rates from 16.3% in 2011 to 24.1% in 2019. Men were less likely to receive osteoporosis treatment after admission for hip fracture. Patients discharged to a facility were more likely to receive osteoporosis treatment. As compared to women, men who had a hip fracture were less likely to receive dual-energy X-ray absorptiometry scan, and osteoporosis medication before hip fracture admission. @*Conclusions@#The use of osteoporosis medication for secondary prevention after admission for hip fracture in Hawaii from 2011 to 2019 was low. However, there was a small increase in treatment rates from 2011 to 2019. Disparities in treatment of osteoporosis after hip fracture were noted in men. Significant work is needed to increase treatment rates further, and to address the disparity in osteoporosis treatment between men and women.
RESUMO
<p><b>OBJECTIVE</b>Hawai'i is an ethnically diverse island state with a high rate of both traditional healing (TH) and complementary and alternative medicine (CAM) use. The aim of this project was to assess TH and CAM use within the pediatric oncology population in Honolulu and improve the delivery of culturally competent care.</p><p><b>METHODS</b>A 9-item survey was distributed to all pediatric oncology patients at Kapi'olani Medical Center for Women and Children for 3 months. The survey inquired about patient ethnicity, TH practices, CAM practices and perception of cultural competence of the care received. Descriptive statistics were calculated for the survey items. Qualitative analysis was done with participant comments to identify themes.</p><p><b>RESULTS</b>Sixty-two surveys were completed. TH was used by 39% of the respondents in the home, and 10% in the hospital (top method was traditional foods). CAM was used by 27% of the respondents in the home, and 68% in the hospital (top method was healing touch). Ninety-seven percent of the respondents reported receiving culturally competent care. Areas for improvement included language services and dietary choices.</p><p><b>CONCLUSION</b>CAM and TH are used frequently by pediatric oncology patients in Hawai'i, and the vast majority of patients and families felt that the care they received was culturally competent.</p>